By Gystilyn O’Brien – 06/02/2019 – unpublished

Sleep deprivation is a major problem in society, given busy schedules and poor nutrition and sleep practices. In the prison system, where tensions are high as a standard, sleep deprivation can cause not only health failure but civil unrest, costing the institution and economy both time and money. Insufficient practices assessing inmates mental and physical struggles within the system can have an overall effect on quality of life for everyone, including the medical staff and correctional officers. Studies have show that sleep deprivation can be rectified by exercise and better diet, proper medical assessment and treatment, and a concise educational program for staff and inmates outlining system challenges and better practices to ensure restful sleep.  

CAUSE

Correctional facilities by their nature come with a series of challenges to cope with regarding population regulation and quality of life. The nature of the population in and of itself, regarding drug addiction, racism, classicism, and gang violence prescribes an environment rich with trauma and hypertension. Add to that poor dietary and exercise practices, interrupted sleep schedules by security checks, and overcrowding, and you have an environment raft with exhaustion and poor health. Worse still, the prison system is often understaffed, underfunded and under educated. This leads to an inability to appropriately manage the population, causing undue strain and stress on the staff. Both inmates and staff show signs of mental, physical and emotional health degeneration such as:

• PTSD

• Hypervigilance and hypertension – ADHD

• Increase in Diabetes

• Impaired Immune system leading to further physical illness

• Mental disorders

• Increased Aggression
  

When a person sleeps it not only gives their mind a chance to reset as input is decreased but it also allows the body to shut off certain physical functions and focus on other functions. For example the stomach and digestive system go into a suspended state while the white blood cells in the body do work on repairing any physical damages done to the body during the day.  The reason a prescribed 7-9 hours of sleep in standard is that it gives the body the chance to accomplish these processes. When sleep is interrupted by sound, hypertension, nightmares (common with PTSD) the body never has a chance to reach these restorative levels. In cases of Sleep Apnea oxygen to the body is reduced by up to 4% which can lead to hypoxemia, a severe oxygen deficiency that can lead to organ failure.

EFFECT:

The effects of sleep deprivation on the individual can be debilitating, yet the effects over a large population can be catastrophic and costly. A large population in a mental state of disassociation, as is one of the first signs of sleep deprivation, will be more likely to act with aggression or in dissociative patterns. Inmates may not be willing or capable of following simple rules and instructions, not unlike being intoxicated, even in regards to their own safety. In such cases damage to correctional officers, facilities and other inmates may the cost the institution in time and medical expenses. Replacing an injured correctional officer may be extremely difficult or impossible, given the nature of under-staffing in this profession.

TREATMENT:

Given the nature of the correctional facilities system there are some standards that must be maintained, such as night security checks to ensure suicide prevention and reduce assault. Inmates are often disturbed in 30 minute intervals by noise and lights throughout the ‘lights-out hours’. In most other cases though the methodology behind time and population management could use an improvement, particularly in context of diet and exercise, visits to the medical staff, and provided education. Such improvements could lead to better self and medical management, and better overall health practices. This would allow inmates to take stronger control of their physical persons and thus how they treat their time and interactions with others.

In 2015 a revised version of the Standard Minimum Rules (The Nelson Mandela Rules) were adopted unanimously by the 70th session of the UN General Assembly with compliance in America. These rules outlined basic standards and rights to inmates including access to nutritional food and water, medical aid and cell regulation to guarantee health and sleep management. In recent years these rules and regulations have seen a lack of inspection and enforcement due to over population and under staffing. Where these issues can not easily be fixed without opening more institutions or court dismissals, regulating time management and information is easy and cheap to accomplish.

• Scheduling rotating medical teams to do rounds, just as correctional officers do for safety checks, would allow better access and the ability for inmates to be checked regularly for health deficiencies such as exhaustion, dehydration and vitamin deficiency. Consistent problem cases would be more regularly reported and assessed, allowing for the treatment of Sleep Apnea or accompanying medical disorders. Present models require inmates to request for medical attention, which given the severity of the issue, may be pushed aside or ignored entirely.
• Implementing a standard exercise program for inmates including walking the yard, yoga or floor exercise may help inmates regulate energy and increase blood flow. It may also help inmates cope with time, where trying to sleep away their sentence, or take naps during the day, only leads to poorer overall sleep at night.
• Informational packets outlining the potential medical risks which come from sleep deprivation would aid inmates in addressing their symptoms. Suggestions on time regulation such as getting regular exercise, having a nighttime ritual to fall asleep (sleep log), or doing breathing practices (mindfulness), may help an inmate schedule their time more effectively. Secondary packets outlining meditative practices to cope with hypertension, hypervigilance and PTSD may also help.

P4: COST:

Where the prison systems under-staffing, under-inspection and quality control is a clear sign of under-funding the truth is that poor practices cost more in damages than changing the system would cost.

In the case of correctional officers the physiological and physical costs of working in the correctional system leads to a life expectancy is 59 years old, 16 years shorter than the national life expectancy standard. Correctional officers suffer on average the same medical issues as inmates, regarding poor nutritional practices, sleep deprivation, and unaddressed mental disorders from PTSD and Hypertension. Correctional Officers have a 39% higher suicide rate than any other occupation, and functionally are served by the same facilities as the inmates.

According to The Pew Charitable Trusts and the Vera Institute of Justice 50-state prison report the ‘departments of correction collectively spent $8.1 billion on prison health care services for incarcerated individuals in fiscal year 2015—probably about a fifth of overall prison expenditures. Health care spending per inmate varied dramatically in fiscal 2015, as it had in past years—from $2,173 in Louisiana to $19,796 in California. State officials across the country need to understand whether and how these differences reflect meaningful discrepancies in value and performance. This knowledge helps states determine if their prison health care systems assist or undermine their efforts to achieve universal goals: meeting constitutional obligations, protecting public safety, strengthening public health, and practicing fiscal prudence.’

Costs to change scheduling and provide information could mean a major reduction in expenses as well as an improved rates in decreased sentences due to good behavior. Proper correction, the goal of such facilities, is intended to aid inmates in learning better life practices to keep them from becoming repeat offenders.

In short, sleep deprivation clearly has a long and overarching effect on the correctional institution infrastructure and is a major cause of civil, mental and emotional unrest in the prison system. With knowledge and attention to improved systems a betterment for the individual, and mankind as whole, can bring great improvement in social health and economy.